NEW MEXICO PUBLIC SCHOOLS INSURANCE AUTHORITY

NEW MEXICO PUBLIC SCHOOLS INSURANCE AUTHORITY Regional Training - Benefits Program August 2012

Today’s Agenda • Claims and fund balance overview • Premium increases • ERISA & the Administration Guide • FMLA • Stress management • Prescriptions • 2012 Program Guide • Value-added benefits from The Standard • Managed Health Care Bureau on appeals • CCMSI and Workers’ Compensation

Benefits Fund Balance

Use of fund balance • October 1, 2007 rate action of 7.4% deferred until February 1, 2008 • October 1, 2008 rate action of 9.9% was decreased to 5.5% for BCBS members • Used $5 million in current year to buy down increase • Possible lowering of proposed rate increase effective October 1, 2012

Revised Increases October 2012 Blue Cross Medical: +6.13% Presbyterian Medical: +6.13%% UCCI Dental: No change Davis Vision: No Change The Standard Life: No Change The Standard LTD: No Change

Two New Changes • Specialty copay reduced from $100 to $75 • Children for all lines of coverage up to age 26 married or not • These changes start October 1, 2012 • Change cards for children must be submitted by September 30

You are our focus group • Pfizer resources at no cost • Service turnaround – stop internalizing • Depression, stress, and other health management materials.

Now, let’s deal with stress

Rule #1 • Positive mental attitude • Expect the best • Realize that you cannot control everything • Stop being so critical of yourself

Rule #2 • Physical Activity • It puts more pep in your steps • It pumps up your endorphins • It is meditation in movement

Rule #3 • Keep a stress journal. • What may have triggered the stress. • How you felt and behaved in response to the stressful situation • What, if anything, you did to cope with the stressful situation.

Rule #4 • Learn a relaxation technique • Breathing (like belly breathing) • Meditation or visualization • Muscle relaxation • Body-shaking • Grounding exercise

Rule #5 • Change your “self-talk: • Eliminate “need”, “have to” & “must” • Replace with “want to” or “would like to” • Know you can stand the consequences of not getting something done

Rule #6 • Maintain your sense of humor • Laughter reduces the level of stress hormones like cortisol & adrenaline. • Laughter connects us with others. Also, laughter is contagious. • Laughter provides a physical and emotional release.

These may work for you • Practice letting go the next time you feel angry • Slow down your speech when you are stressed • Plan a reward at the end of the day • Elevate - Will this matter one year from now?

Heads Up • PPACA – Patient Protection and Affordable Care Act requires cost of employer provided benefits to be reported on W-2 • For 2012 W-2’s • NMPSIA assessed a tax to help support PPACA’s Comparative Effectiveness Research Fee. This will cost us $113,000 in FY 13

July 1, 2012 Program Guide • Three mistakes in Program Guide • Page 42, In-Network maximum s/b $1,500 • Page 46 Pres Low Option Family s/b $399.90 • Page 46 BCBS High Option, 2nd box, Family s/b $467.30 • Page 47, ADL 65-69 s/b $.78 Page 15, Specified Disease benefit Page 16, Accelerated Benefit now available to spouse Page 26, Autism coverage Pages 35 & 36, new Rx copays Pages 44 & 45, updated Vision summary

Let’s do some drugs

Patent expirations • Actoplus Met • Actos • Avandia • Clarinex OR & D • Diovan and Diovan HCT • Lexapro • Lunesta

Patent expirations • Plavix • Provigil • Seroquel • Singulair • In 2013: • Fosamax Plus D • Cymbalta

You are now free to move about the cabin • Any More Questions? • Comments? • Thanks! Let’s Break for Lunch

NEW MEXICO PUBLIC SCHOOLS INSURANCE AUTHORITY